By LEE BOWMAN
Scripps Howard News Service

Backed by an $11 million grant from the Gates Foundation, the infant-survival group First Candle has launched a new program of crib giveaways and education aimed at giving every baby a safe place to sleep.

Through the grant from the Bill and Melinda Gates Foundation announced Monday, First Candle plans to distribute as many as 200,000 cribs and attempt to give parents both the equipment and the information to ensure a safe sleep environment for their baby.

Experts estimate that at least 50 percent of more than 4,000 sudden unexpected infant deaths that occur each year could be prevented if babies were placed in a safe spot and position every time they're laid down to sleep, day and night.

The initiative comes as Scripps Howard News Service continues a review of how the nation investigates and classifies infant deaths. Scripps has found that while national statistics show about one in six of sudden infant deaths are due to accidental suffocation, incomplete probes and biased diagnoses may mask the true causes of many other deaths.

An analysis by Scripps found that twice as many babies, more than 15 percent, are found to die from accidental suffocation in states that carry out independent reviews of child deaths at both the local and state level, compared to only 7 percent of infant deaths in states where there is no review of child deaths.

A national campaign for a safer infant sleep environment was started in the mid-1990s and continues today. But that program emphasized "Back to Sleep" over other aspects of baby sleep surroundings in a bid to reduce the risk of Sudden Infant Death Syndrome.

The SIDS death rate did drop, by some 30 to 40 percent, but has since leveled off, prompting many child health experts to suspect that other factors besides back-sleeping put babies in danger.

Several local and regional studies in recent years have found that up to 75 percent o f sudden infant deaths were accompanied by such unsafe sleep practices as an adult or sibling sharing a bed, chair or sofa with a sleeping baby -- often known as co-sleeping -- or keeping crib bumpers, pillows or bedding around the tot.

Several cities, such as Detroit, Baltimore and Philadelphia, have started their own safe sleep efforts, including crib give-aways, in recent years. But no one knows for sure what effect such interventions have on infant deaths in the long term.

"There's a constant turnover of new parents that we have to reach, and many of them get a lot of mixed signals, even from health care providers, about how their babies should sleep,'' said Dr. Fern Hauck, a SIDS researcher at the University of Virginia in Charlottesville. She was one of several experts to present research on infant co-sleeping and other practices among low-income moms from various ethnic and cultural backgrounds earlier this week during the annual meeting of the American Public Health Association in Washington.

But the safe sleep message has to reach all new parents.

"We know from our counseling efforts that co-sleeping happens with about 90 percent of all sudden infant deaths,'' said Laura Reno, public affairs director for First Candle, headquartered in Baltimore.

The group's sleep campaign will also include a research team, led by Dr. James Kemp, a noted SIDS researcher now at Washington University and St. Louis Children's Hospital and Dr. Rachel Moon, a researcher at Children's National Medical Center and George Washington University in Washington.

The program will target the states of Indiana and Washington as well as the District of Columbia. The researchers plan to track more than 100,000 families who get cribs, information and support on safe sleep practices starting before their baby is born through the first year. They'll also closely follow infant death patterns in the targeted states.

First Candle and the researchers hope that providing the cribs and educational programs will result in a significant reduction in infant deaths.

Moon, who also presented research at the APHA meeting, said studies showing more than 35 percent of mothers reporting they start the night sleeping with their babies "is probably an underestimate,'' and also noted that inconsistencies in infant death diagnoses are likely hiding the extent of the danger.

"We don't have the data to say that X percent of infant deaths are due to parents sleeping with their baby, so we're going to try and see what happens with infant deaths when more parents are encouraged not to co-sleep," Moon said.

"Through Bedtime Basics for Babies, we hope to build on the success of the Back to Sleep campaign and have an even greater impact on saving infant lives,'' said Marian Sokol, president of First Candle, which changed its name from the SIDS Alliance several years ago to reflect a wider focus on promoting infant health and safety from the prenatal period through age 2.

"We hope the Bedtime Basics program and research will save more infant lives, providing families with the safe sleep equipment and information they need,'' said Patty Stonesifer, chief executive of the Gates Foundation, who had already helped organize a small crib donation program in Indiana.

First Candle will be working with public and private groups that are already involved in working with new parents and infant mortality prevention in each jurisdiction. Reno said families would be referred to the program through a health care provider and set up with a visiting nurse or other specialist who can guide the parents on creating a safe sleep area in and around the crib.

On the Net: http://www.firstcandle.org